Supporting PDA children with personal hygiene

They may experience a number of sensory sensitivities which causes them discomfort. Keeping clean can also involve a lot of demands which need to be repeated on a regular basis. Often hygiene tasks are put at the start of the day. This can prove to be a barrier to getting going on other things and cause the whole day to get off on the wrong foot.

• It seems pointless: they might wonder why they need to bother with some hygiene tasks. Your PDA child may benefit from a gentle, age-appropriate explanation of why the task is required. If they can understand the importance hygiene they might make the choice themselves to participate.
• Sensory sensitivities: personal hygiene activities often involve a sensory change which can be triggering for PDAers. Your child might find certain sensations very unpleasant. It might be that they cannot communicate this to you using words and so will show you using behaviour. They may lash out or avoid the task to stop themselves from feeling such discomfort.
• Demand avoidance: being asked to do lots of hygiene tasks on a regular basis can feel overwhelming. Your PDA child might manage to brush their teeth a couple of times one week. But this can lead to an expectation they will be able to do it again and again.

Understanding how things like this can affect your PDA child can help you work together to find a way forward.

Giving your PDA child as much choice as possible around hygiene tasks can help them feel more in control. Letting them know that it’s okay not to do the task can take the pressure off and give them a chance to choose doing it. It can be a way of reclaiming control, so you feel less avoidance.  Other ways to help could be by:

• Time and frequency: the task alone can be enough of a demand. Try asking yourself does this really need to be done at a set time, or can we be flexible? Does it need to be done regularly, or could it be ad hoc? Approaching hygiene from an ‘anything is better than nothing’ point of view lowers everyone’s stress.
• How they do it: helping them to find ways to reduce discomfort by doing things differently and on their terms. It might be that they prefer to have you brush their hair downstairs while they’re watching a programme. Or they may choose to brush their teeth with a finger covering rather than a normal toothbrush. You could even try washing outside using a hose in the summer months!
• Separating tasks: try avoiding bunching tasks together. It might seem like a good idea to do all hair related tasks at the same time for example. By leaving hair in a towel after washing, or brushing later in the day, you can help to prevent overwhelm.
• Using fun tools: there are lots of products you can try with your PDAer to make hygiene tasks more exciting. Crazy colour bath bombs, bath crayons and foams can be a fun distraction for children of all ages. Using a toothbrush with their favourite character on it and having different or flavourless toothpaste might encourage them to brush their teeth.

You might find that what works one day may not work the next and that’s okay. Offering a couple of different options and keeping things flexible can help your PDAer to feel in control of what they’re doing.

Letting go and accepting that sometimes it isn’t possible for your PDA child to do the task can take the pressure off everyone. Having a break and trying again another day when people are in a better place could be a healthy approach.

Our parent carer training could be for you. It’s built by people with lived experience, and is full of practical tips. Families tell us that after our training they better understand what is going on for their child, why they are struggling and what they can do to help.